Wound reopens

[spotbird]

Around six weeks ago I had my gall bladder removed laparoscoply, I had no stones but pain and an ejection faction of 8%.  The surgery went perfectly, the only comment the surgeon had afterward was that adhesions almost caused him to have to perform the surgery the traditional way. Postoperatively once some constipation problems were resolved, I felt fantastic; better than I had for a long time.

Last week (five weeks since surgery) I noticed that the scar under my belly button had little blood blisters on it.  Later in the day those blisters burst and the incision appeared to be open.  The next day I visited the surgeon who said there was nothing to worry about, the dissolving stitches caused the problem. I don’t think he believed me that it was healed and reopened; he acted like it had been open all along.

Over the next few days the wound began to drain yellow stuff, since it was over the weekend I didn’t call the surgeon again, instead I started myself on antibiotics, realizing I didn’t have enough for a full coarse. After a day on the antibiotics the drainage stopped, but the incision remained open.

That Monday I called the surgeon’s office to explain the changes in the wound. He told me that it was not infected when he’s seen it last week and it would heal eventually. He told me he’d would look at it again, but there wasn’t much point since there was no longer apparent infection. The doctor only viewed this wound as a problem if there was obvious infection. He would not agree to prescribe the rest of the coarse of antibiotics based on his observations the previous week.

Today the wound is draining pus; if you saw it you’d think the operation was yesterday. Other doctors won’t even let me make an appointment since a wound infection is the surgeon’s problem.   The surgeon acts like I’m insane, that it is perfectly normal to have an open wound a month after the operation.  

Why would a wound reopen so late? What can I do now?

I’m to the point of tears.

[Kevin Pho, MD]

I would ensure that there is no infection - if there is pus, then certainly an infection is possible.  If you are not comfortable with the surgeon's diagnosis, you can consider another opinion.  

You may also want to ensure that other conditions that may affect wound healing is controlled.  This can include diabetes, the use of steroids, as well as poor nutritional status.  

These options can be discussed with your personal physician.  Another option would be to seek to care of a wound care specialist (in most cases a nurse working in conjunction with a surgeon).

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[dcdre14]

I would call the surgeon back and demand an appointment immediately.

If he still refuses and no other doctors will see you ASAP, go to the ER at the hospital where the surgery was performed.

A post-op infection isn't something to be taken lightly.  I developed one after I had a hernia repaired about a year ago... it wasn't fun.

If you do end up going to the ER, and if it does, indeed, turn out to be an injection, I'd report the surgeon... at least to the hospital!

Good luck,
ED

[yoshi]

or have your lawyer speak to his lawyer !or how about the AMA??

[JackieG]

It's really not that unusual to have incisions heal from the inside out. You should be sure there is no infection, but the incision will heal OK from the inside out. It just takes a bit more time.

[Dr_Geong]

A related discussion, Answer, not a question was started.